Table 1

Summary of studies included in the review

Authors (date) and countrySamplesBaseline characteristicsNCCP diagnostic tests
Aikens et al (1999) USA24NCCP=80
  • 46% male

  • Mean age 50.3 years (SD=13.3)

12–23 h of intensive observation and evaluation, including cardiac monitoring, enzyme analysis, toxicology screen, and stress echocardiography. 7% also underwent cardiac catheterisation
Demiryoguranet al (2006) Turkey25NCCP=157
  • 43.3% male

  • Mean age 41.6 years (SD=11.7, range 18–64)

ECG, chest x-ray, followed up in ED for 6–8 h. Does not explicitly state what tests done but does refer to cardiac markers. Further investigation done for other non-cardiac causes when necessary
Eken et al (2010) Turkey26
  • NCCP=194

  • CCP=130

  • 67% male

  • Mean age 50.5 years (SD=14)

Serial ECG and cardiac enzymes for 6 h after symptom onset
Eslick and Talley (2008) Australia27
  • NCCP=126

  • CCP=71

  • 61.4% male

  • Mean age 58 years (SD=14)

  • NCCP: 54.0% male

  • CCP: 75.6% male

x-ray, troponin and CKMB, BP, temp, resting ECG and exercise stress test. Judgement made by physician
Fagring et al (2008),20 Jerlock et al (2008)5 Sweden
  • NCCP=231

  • Population-based controls=1069

  • NCCP: 55% male, mean age 46.6 years (SD=11.5)

  • Controls: 46% male, mean age 47.9 years (SD=12.3)

Patients were assessed and treated ‘according to the routines of the ED’
Kuijpers et al (2003) The Netherlands22NCCP=884
  • Data not available on full sample.

  • Patients scoring above 8 on HADS for anxiety OR depression 53.8% male, mean age 55.8 years (SD=13.03)

Full history, physical exam, and ECG for all patients. Cardiac enzymes and troponin, exercise stress test, echocardiogram and x-ray as deemed appropriate according to standard practice
Mayou and Thompson (2002) UK28
  • NCCP=107

  • CCP=218

  • NCCP: 63% male, mean age 53.07 years (SD=12.2)

  • CCP: 65% male, mean age 65.46 years (SD=9.3)

IHD excluded, according to guidelines. No information on this
Shahid et al (2004) Pakistan29NCCP=5064% male. No data on agePhysical exam and ECG
Soares-Filho et al (2009) Brazil30
  • Pain of undetermined cause (NCCP)=71

  • Pain of determined cause=59

  • 58.5% male, mean age 61.2 (SD=13.2, range 31–87)

  • NCCP: 53.5% male, mean age 61.9 years (SD=12.8)

  • Determined cause: 64.4% male, mean age 60.4 years (SD=13.6)

Upon admission and every 3 h after CKMB and troponin-I were assessed, an 18-lead ECG on arrival and 12-lead ECG every 3 h after, most patients underwent an echocardiogram. When no MI or rest ischaemia found, exercise stress test, or myocardial scintigraphy was performed
Srinivasan and Joseph (2004) India23
  • NCCP=109

  • CCP=206

  • NCCP: 55.0% male, mean age 39.68 years

  • CCP: 78.6% male, mean age 56.5 years

CAD diagnosed as either documented MI, coronary bypass surgery, angioplasty, coronary angiogram indicative of significant stenosis, abnormality on a treadmill test. NCCP is therefore absence of these
  • BP, blood pressure; CAD, coronary artery disease; CCP, cardiac chest pain; CKMB, creatine kinase, myocardial type; ED, emergency department; IHD, ischaemic heart disease; MI, myocardial infarction; NCCP, non-cardiac chest pain.